How Fast Does COPD Progress?

Dealing with COPD can make even simple tasks feel difficult — COPD can have an immense impact on the quality of a patient’s life, especially in its later stages.

But how fast does COPD progress, and what are the early signs that a patient might have this condition? Today, Carda is here to talk about COPD, disease progression, and treatment options. Read on to learn how to support overall lung function and pulmonary health with Carda.

What Is COPD?

COPD stands for chronic obstructive pulmonary disease and refers to a diagnosis of a group of progressive lung diseases.

"Chronic" means that the diseases are long-term, and "obstructive pulmonary" means that the diseases block air such that your lungs cannot effectively move oxygen in or out. "Disease" indicates lung damage, namely to the smaller airways and to the actual lung tissue.

With COPD, excess mucus buildup in your lungs causes inflammation and subsequent airway blockages. The airflow obstructions diminish your oxygen intake, which can leave you feeling short of breath.

What Diseases Does COPD Include?

The name COPD can be misleading — it refers to a group of lung diseases, not just one. The two main diseases that comprise COPD are emphysema and chronic bronchitis. Usually, a COPD diagnosis involves a combination of both lung conditions.

Emphysema is a lung disease involving damage to the walls of your alveoli, so they can no longer transfer oxygen to your blood as effectively. As a result, your lungs stretch, and your airways can become droopy or saggy, which can hold more air in your lungs and make you feel short of breath.

Chronic bronchitis involves damage to the bronchial tubes in your lungs, such that they lose their cilia fiber lining. As a result, your bronchial tubes swell and become irritated, which can cause you to cough and make it more difficult to get rid of phlegm. Bronchitis becomes chronic if the cough lasts for three months or longer, for two years in a row.

What Are the Early Signs of COPD?

The early stages of COPD can be hard to detect, and it is not uncommon to go without a diagnosis until later stages in your disease progression.

Some people do not even experience symptoms at all in the initial stages of this disease. However, as their disease progresses and they do start to experience symptoms, early signs include:

  • Shortness of breath
  • Frequent and persistent coughing
  • Wheezing
  • A "tight" or "crushing" sensation in the chest

Shortness of breath, also known as dyspnea, is often the first symptom to present with COPD. With dyspnea, you might notice that your exercise capacity decreases, such that you have more trouble breathing during exercise.

Persistent coughing is another common symptom that can present earlier on in COPD progression. Your cough may be dry (without phlegm) or wet (with mucus that is either clear, white, yellow, or green).

How Fast Does COPD Progress?

In general, COPD progresses gradually — symptoms first present as mild to moderate and slowly worsen over time. Often, patients live with mild COPD for several decades before the disease progresses to moderate or severe.

However, each patient is unique. Although it is not as common, some COPD cases quickly progress from mild to moderate in just a few months.

What Are the Stages of COPD?

There are four COPD stages, and healthcare providers use the GOLD standard to classify the stages of your pulmonary disease based on severity. The system derives from the Global Initiative for Chronic Obstructive Lung Disease (GOLD), and incorporates input from the National Heart, Lung, and Blood Institute as well as the World Health Organization.

Each numbered stage evaluates your forced expiratory volume (FEV1), which is how much air you breathe out in your first second of exhalation with spirometry, which is a breathing test. If your FEV1 is 80% or higher, you have stage 1 COPD (mild). In stage 2 (moderate COPD), you have an FEV1 between 50-79%.

Stages 3 and 4 are severe COPD and very severe COPD, respectively — in stage 3, your FEV1 is between 30 to 50%, and in stage 4, your FEV1 is less than 30%.

In addition to the numbered stages that assess how severe the damage to your lung function is, the GOLD system also uses an ABCD rubric to assess what impact your symptoms of COPD have on your overall health.

What Are the Warning Signs That COPD Is Worsening?

If you experience shortness of breath more frequently and with more day-to-day activities such as doing things around the house or walking, then your COPD is likely worsening. Other signs that your COPD could be worsening include:

  • Exacerbations in your shortness of breath or wheezing
  • Breathlessness
  • More persistent chest tightness
  • Physical and mental fatigue
  • A change in your cough (from dry to wet or a change in mucus color)
  • More frequent chest infections

How Does Late-Stage COPD Impact Life?

Late-stage COPD can greatly impact the quality of your life to the extent that it becomes hard to leave your home or even your chair.

You might find it hard to breathe even if you are sitting down or doing tasks that require little to no movement, such as talking or eating. You might also experience weight loss, a more bulging or rounded chest, less time between your symptom flare-ups, and blue lips or fingers due to severe oxygen depletion.

How Is COPD Treated at Each Stage?

Stage 1

During stage 1 COPD, your healthcare provider might not recommend treatment yet, especially if you experience little to no symptoms. If they do think treatment is necessary, they will likely prescribe you a bronchodilator medication (to take through an inhaler or nebulizer) that widens your airway passages to help you breathe more easily.

Stage 2

During stage 2 COPD, if your symptoms remain on the more mild to borderline moderate side, your doctor may just keep you on a bronchodilator without adding other treatment.

However, if your symptoms progress to the more moderate side, they might suggest that you attend a pulmonary rehabilitation program. This program is a group class that fosters awareness and management practices for your symptoms and disease progression.

As stage 2 progresses, you might begin to experience COPD flare, or concentrated periods of time where your symptoms worsen. Healthcare providers often prescribe steroids or supplemental oxygen when you experience flare-ups.

Stage 3

At this point in your condition, common treatments involve maintaining stage 2 interventions such as bronchodilators and pulmonary rehabilitation programs, such as Carda. It is also far more common to start using an oxygen tank during stage 3.

Stage 4

Because your blood oxygen levels are very depleted and you could experience respiratory failure during this late and most severe COPD stage, your healthcare provider will likely build off of your treatment plan from stage 3. They may recommend a pulmonary surgery, like a lung transplant, to help alleviate symptoms.

Is It Possible To Prevent COPD From Progressing?

Unfortunately, it is impossible to fully prevent COPD from progressing, as this disease is chronic and there is no cure. However, while you cannot stop progression, you can take steps to slow it down and utilize the oxygen you have available more efficiently and effectively.

Leading a healthy lifestyle with a well-balanced diet and some physical activity can significantly affect how fast or slow your COPD advances. Exercise can be hard with dyspnea, but even 30 minutes a week can help to strengthen your lung muscles and slow disease progression. Breathing exercises can also help strengthen your lungs.

Working to quit smoking can support lung health overall. Cigarette smoking is the leading cause of COPD, and it is never too late to quit.

Additionally, ensure that you stay up to date on all your vaccines, as COPD can make you more susceptible to illnesses and infections. You should also try to avoid lung irritants, such as air pollution, secondhand smoke, or strong fragrances.

If you are looking for life-saving care to help slow the progression of COPD from the comfort of your own home, Carda is here to help. With at-home virtual care on your own schedule, our experts adjust everything from your prescribed exercise regimen to stress management techniques based on your needs.

Get started today and take our free assessment to get paired with an expert physiologist to help support you through your COPD journey every step of the way.

The Bottom Line

COPD is a group of two progressive lung diseases — emphysema and bronchitis. There is no cure for COPD, and while there is no way to prevent disease progression, it is possible to help slow that progression. Maintaining frequent healthcare visits and sticking to the treatment regimen a doctor prescribed are crucial parts of the process.

With some healthy lifestyle changes and support from Carda Health, it is possible to slow COPD advancement, which can help enhance overall quality of life.


COPD: Symptoms, Diagnosis, and Treatment | CDC

Epidemiology of COPD | European Respiratory Society

The GOLD Standard for Chronic Obstructive Pulmonary Disease | American Journal of Respiratory and Critical Care Medicine

Treating COPD | American Lung Association

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